Univeristy of Maryland, Baltimore

University of Maryland, Baltimore
Environmental Health and Safety

HOT WORKS PERMIT

Before any job, task or operation associated with the following (producing heat, sparks, open flames and or smoke), this hot work permit is required to be filled out and signed by the operation supervisor who will be competent with regard to Hot Work. This permit must be posted at the operation site. If for any reason, the permit can not be fully completed or the precautions listed under this permit can not be met, hot work is prohibited.
Hot Work Done by: Company/Contractor Name:
Contractor Facilities Management
Date:
Work Order Number:
Select Building where work will occur:
Enter Floor or Room where work will occur:
Nature of Work:
Hot Work Operator Name(s):
I verify the information on this hot work permit is corrrect and, furthermore, that the above location has been examined for the precautions listed on this permit to prevent fire.
Name of Operations Supervisor: First Last
Contact No:
Fax:
Email:
Permit Request Effective Date: (i.e. 04/09/05)     Today is 08/29/08.
Permit Request Estimated Start Time: (i.e. 9:30)
Permit Request Expiration Date: (i.e. 04/09/05)
Permit Request Estimated Completion Time: (i.e. 9:30)

Final approval of this permit takes place ONLY after an EHS representative has seen the location and signed and posted the permit. No hot work can take place until the EHS approval occurs.

Questions or comments regarding this permit can be directed to Robert Burke, 6x3494, UMB Fire Marshal or Nick Wellnitz, 6x3490, UMB Occupational Safety Associate.

IN CASE OF FIRE, DIAL 711

You must agree to adhere to the following precautions by checking each item.

All equipment to be used has been inspected and is in good repair.
Floors and surrounding area are clear of combustible materials within 35 feet of the work area.
Materials that cannot be moved are protected with noncombustible material or cover.
Floor openings within 35 feet are tightly covered.
A responsible fire watcher has been assigned to watch for dangerous sparks in area, as well as floors above and below and will remain on the job site for 30 minutes after completion of hot work.
Appropriate fire extinguishing equipment is within 10 ft. of work site. (company/contractor provides their own fire extinguishing equipment)
The sprinkler system, where provided, is in service.
Appropriate arrangements have been made with UMB Work Control Center (x6-7570) to prevent the accidental activation of fire detection and alarm systems. Call 405-2222 for outages.
There are no flammable liquids, vapors, dusts, lints OR equipment containing such materials in the work area.